| Devices, systems, and methods for reshaping a heart valve annulus -> Monitor Keywords |
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Devices, systems, and methods for reshaping a heart valve annulusRelated Patent Categories: Prosthesis (i.e., Artificial Body Members), Parts Thereof, Or Aids And Accessories Therefor, Heart Valve, Annuloplasty DeviceDevices, systems, and methods for reshaping a heart valve annulus description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20060106456, Devices, systems, and methods for reshaping a heart valve annulus. Brief Patent Description - Full Patent Description - Patent Application Claims
RELATED APPLICATIONS [0001] This application claims the benefit of co-pending U.S. patent application Ser. No. 09/666,617, filed Sep. 20, 2000 and entitled "Heart Valve Annulus Device and Methods of Using Same," which is incorporated herein by reference. This application also claims the benefit of Patent Cooperation Treaty application Ser. No. PCT/US 02/31376, filed Oct. 1, 2002 and entitled "Systems and Devices for Heart Valve Treatments," which claimed the benefit of U.S. Provisional Patent Application Serial No. 60/326,590, filed Oct. 1, 2001, which are incorporated herein by reference. This application also claims the benefit of U.S. Provisional Application Serial No. 60/429,444, filed Nov. 26, 2002, and entitled "Heart Valve Remodeling Devices;" U.S. Provisional Patent Application Serial No. 60/429,709, filed Nov. 26, 2002, and entitled "Neo-Leaflet Medical Devices;" and U.S. Provisional Patent Application Serial No. 60/429,462, filed Nov. 26, 2002, and entitled "Heart Valve Leaflet Retaining Devices," which are each incorporated herein by reference. FIELD OF THE INVENTION [0002] The invention is directed to devices, systems, and methods for improving the function of a heart valve, e.g., in the treatment of mitral valve regurgitation. BACKGROUND OF THE INVENTION I. The Anatomy of a Healthy Heart [0003] The heart (see FIG. 1) is slightly larger than a clenched fist. It is a double (left and right side), self-adjusting muscular pump, the parts of which work in unison to propel blood to all parts of the body. The right side of the heart receives poorly oxygenated ("venous") blood from the body from the superior vena cava and inferior vena cava and pumps it through the pulmonary artery to the lungs for oxygenation. The left side receives well-oxygenation ("arterial") blood from the lungs through the pulmonary veins and pumps it into the aorta for distribution to the body. [0004] The heart has four chambers, two on each side --the right and left atria, and the right and left ventricles. The atria are the blood-receiving chambers, which pump blood into the ventricles. A wall composed of membranous and muscular parts, called the interatrial septum, separates the right and left atria. The ventricles are the blood-discharging chambers. A wall composed of membranous and muscular parts, called the interventricular septum, separates the right and left ventricles. [0005] The synchronous pumping actions of the left and right sides of the heart constitute the cardiac cycle. The cycle begins with a period of ventricular relaxation, called ventricular diastole. The cycle ends with a period of ventricular contraction, called ventricular systole. [0006] The heart has four valves (see FIGS. 2 and 3) that ensure that blood does not flow in the wrong direction during the cardiac cycle; that is, to ensure that the blood does not back flow from the ventricles into the corresponding atria, or back flow from the arteries into the corresponding ventricles. The valve between the left atrium and the left ventricle is the mitral valve. The valve between the right atrium and the right ventricle is the tricuspid valve. The pulmonary valve is at the opening of the pulmonary artery. The aortic valve is at the opening of the aorta. [0007] At the beginning of ventricular diastole (i.e., ventricular filling)(see FIG. 2), the aortic and pulmonary valves are closed to prevent back flow from the arteries into the ventricles. Shortly thereafter, the tricuspid and mitral valves open (as FIG. 2 shows), to allow flow from the atria into the corresponding ventricles. Shortly after ventricular systole (i.e., ventricular emptying) begins, the tricuspid and mitral valves close (see FIG. 3)--to prevent back flow from the ventricles into the corresponding atria--and the aortic and pulmonary valves open--to permit discharge of blood into the arteries from the corresponding ventricles. [0008] The opening and closing of heart valves occur primarily as a result of pressure differences. For example, the opening and closing of the mitral valve occurs as a result of the pressure differences between the left atrium and the left ventricle. During ventricular diastole, when ventricles are relaxed, the venous return of blood from the pulmonary veins into the left atrium causes the pressure in the atrium to exceed that in the ventricle. As a result, the mitral valve opens, allowing blood to enter the ventricle. As the ventricle contracts during ventricular systole, the intraventricular pressure rises above the pressure in the atrium and pushes the mitral valve shut. [0009] The mitral and tricuspid valves are defined by fibrous rings of collagen, each called an annulus, which forms a part of the fibrous skeleton of the heart. The annulus provides attachments for the two cusps or leaflets of the mitral valve (called the anterior and posterior cusps) and the three cusps or leaflets of the tricuspid valve. The leaflets receive chordae tendineae from more than one papillary muscle. In a healthy heart, these muscles and their tendinous cords support the mitral and tricuspid valves, allowing the leaflets to resist the high pressure developed during contractions (pumping) of the left and right ventricles. [0010] In a healthy heart, the chordae tendineae become taut, preventing the leaflets from being forced into the left or right atria and everted. Prolapse is a term used to describe this condition. This is normally prevented by contraction of the papillary muscles within the ventricle, which are connected to the mitral valve leaflets by the chordae tendineae. Contraction of the papillary muscles is simultaneous with the contraction of the ventricle and serves to keep healthy valve leaflets tightly shut at peak contraction pressures exerted by the ventricle. II. Characteristics and Causes of Mitral Valve Dysfunction [0011] In a healthy heart (see FIG. 4), the dimensions of the mitral valve annulus--when measured septal (S)- to -lateral (L), as well as from posterior commissure CP to anterior commissure CA--create an anatomic shape and tension such that the leaflets coapt, forming a tight junction, at peak contraction pressures. Where the leaflets coapt at the opposing medial and lateral sides of the annulus are called the leaflet commissures, and are designated in FIG. 4 and in other Figures as CP(denoting the posterior commissure) and CA (denoting the anterior commissure). [0012] Valve malfunction can result from the chordae tendineae (the chords) becoming stretched, and in some cases tearing. When a chord tears, the result is a leaflet that flails. Also, a normally structured valve may not function properly because of an enlargement of or shape change in the valve annulus. This condition is referred to as a dilation of the annulus and generally results from heart muscle failure. In addition, the valve may be defective at birth or because of an acquired disease. [0013] Regardless of the cause (see FIG. 5), mitral valve dysfunction can occur when the leaflets do not coapt at peak contraction pressures. As FIG. 5 shows, the coaptation line of the two leaflets is not tight at ventricular systole. As a result, an undesired back flow of blood from the left ventricle into the left atrium can occur. This condition is called regurgitation. [0014] In some cases (see FIG. 6), the leaflets do not form a tight coaptation junction because the dimensions of the mitral valve annulus, measured from commissure to commissure--CP to CA--and/or septal to lateral--S to L--change. The changed dimensions no longer create the anatomic shape and tension in which the leaflets coapt at peak contraction pressures. [0015] Comparing a healthy annulus in FIG. 4 to an unhealthy annulus in FIG. 6, the unhealthy annulus is dilated and, in particular, the septal-to-lateral distance is increased. As a result, the shape and tension defined by the annulus becomes less oval (see FIG. 4) and more round (see FIG. 6). This condition is called dilation. When the annulus is dilated, the shape and tension conducive for coaptation at peak contraction pressures progressively deteriorate. Instead, at peak contraction pressures, the leaflets do not coapt completely, and a gap forms between the leaflets. During ventricular systole, regurgitation can occur through this gap. It is believed that the ratio between the commissure distance and septal-to-lateral distance bears a relationship to the effectiveness of leaflet coaptation. If the septal-to-lateral distance increases, the ratio changes, and when the ratio reaches a certain value, regurgitation or the likelihood of regurgitation is indicated. [0016] As a result of regurgitation, "extra" blood back flows into the left atrium. During subsequent ventricular diastole (when the heart relaxes), this "extra" blood returns to the left ventricle, creating a volume overload, i.e., too much blood in the left ventricle. During subsequent ventricular systole (when the heart contracts), there is more blood in the ventricle than expected. This means that: (1) the heart must pump harder to move the extra blood; (2) too little blood may move from the heart to the rest of the body; and (3) over time, the left ventricle may begin to stretch and enlarge to accommodate the larger volume of blood, and the left ventricle may become weaker. [0017] Although mild cases of mitral valve regurgitation result in few problems, more severe and chronic cases eventually weaken the heart and can result in heart failure. Mitral valve regurgitation can be an acute or chronic condition. It is sometimes called mitral insufficiency. III. Prior Treatment Modalities [0018] In the treatment of mitral valve regurgitation, diuretics and/or vasodilators can be used to help reduce the amount of blood flowing back into the left atrium. An intra-aortic balloon counterpulsation device is used if the condition is not stabilized with medications. For chronic or acute mitral valve regurgitation, surgery to repair or replace the mitral valve is often necessary. Continue reading about Devices, systems, and methods for reshaping a heart valve annulus... Full patent description for Devices, systems, and methods for reshaping a heart valve annulus Brief Patent Description - Full Patent Description - Patent Application Claims Click on the above for other options relating to this Devices, systems, and methods for reshaping a heart valve annulus patent application. ###  How KEYWORD MONITOR works... a FREE service from FreshPatents1. Sign up (takes 30 seconds). 2. Fill in the keywords to be monitored. 3. Each week you receive an email with patent applications related to your keywords. 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